Guided Lecture Notes

Chapter 21: Assessment of Respiratory Function

Learning Objective 1. Describe the structures and function of the upper and lower respiratory tracts.

· Describe the basic purpose of the respiratory system the upper respiratory system and the lungs. (Refer to PowerPoint slide 2)

· Describe the structures of the upper respiratory system.

· Explain the functions of each of these structures. (Refer to PowerPoint slides 3-8)

· Describe the structures of the lower respiratory system.

· Describe the alveoli. Explain the structure and function of the alveolar capillary membrane in relation to the exchange of gases. Describe the types of alveolar ceils. Explain the function of surfactant.

· Explain the functions of each of these structures. (Refer to PowerPoint slides 9-12)

Learning Objective 2. Describe ventilation, perfusion, shunting and the relationship of pulmonary circulation to these processes.

· Explain the mechanism of ventilation- the movement of air in and out of the lungs. Students frequently have difficulty with this concept. (Refer to PowerPoint slide 13)

· Define and explain respiration. Note that respiration is not breathing but refers to the exchange of gases even though we count “respirations” and assess “respirations.” (Refer to PowerPoint slides 14-15)

· Define pulmonary perfusion

· Define ventilation perfusion (V/Q) ratio and explain the four types of V/Q states. Describe perfusion, shunting and the relationship with pulmonary circulation. Explain the results of hypoxia and respiratory distress due to shunting or increased dead space. (Refer to PowerPoint slides 16-18)

Learning Objective 3. Discriminate between normal and abnormal breath sounds.

· Demonstrate or describe the auscultation of the lungs.

· Explain the landmarks of the chest and the location and sequencing of ausculatory sites.

· Note that auscultation at each site should be for a full inspiration and expiration and valid interpretation may require two full inspirations and expirations at a site.

· Describe the normal and abnormal sounds. (Refer to PowerPoint slides 19 - 21)

Learning Objective 4. Use assessment parameters appropriate for determining the characteristics and severity of the major symptoms of respiratory dysfunction.

· Discuss basic lung capacities and their relationship to the assessment and severity of pulmonary dysfunction. (Refer to PowerPoint slide 22)

· Describe the assessment of tidal volume and peak expiratory flow with a spirometer.

· Define and describe the assessment of inspiratory force.

· Discuss the implications of TV, peak flow rate, and inspiratory force results on patient care management. (Refer to PowerPoint slides 23 -24)

· Briefly discuss arterial blood gases. This material is covered in another chapter. (Refer to PowerPoint slide 25)

· Describe pulse oximetry. Explain the method by which this works and state the normal values.

· Explain factors which may interfere with the reliability of pulse oximetry readings. (Refer to PowerPoint slides 26-27)

· Discuss the oxyhemoglobin dissociation curve and its significance in interpreting pulse oximetry values.

Learning Objective 5. Identify the nursing implications of the various procedures used for diagnostic evaluation of respiratory function.

· List the procedures used in the diagnosis of respiratory function.

· Describe each of these procedures and discuss the nursing implications for care.

· Include specific nursing interventions related to each of the procedures in this discussion. (Refer to PowerPoint slides 28 - 31)

1